{%include file="m.index.header.tpl.php"%}<!--头部 end-->
<!--主体部分-->
<div class="container" style="margin-top:70px;">
    <div class="row row_margin">
        <form class="form-horizontal" role="form" action="" method="post">
            <div class="form-group">
                <label for="inputEmail3" class="col-sm-2 control-label">班级名称:</label>
                <div class="col-sm-10">
                    <select class="form-control" name="class_id"  id="class_id">
                        <option value="">请选择</option>
                        {%foreach from=$class_lists key=key item=value%}
                        <option value="{%$value.class_id%}">{%$value.class_name%}</option>
                        {%/foreach%}

                    </select>
                </div>
            </div>
            <div class="form-group">
                <label for="inputEmail3" class="col-sm-2 control-label">学生姓名:</label>
                <div class="col-sm-10">
                    <select class="form-control" name="student_id" value="student_id" id="student_id">
                        {%foreach from=$student_lists key=key item=value%}
                        <option value="{%$value.student_id%}">{%$value.student_name%}</option>
                        {%/foreach%}
                    </select>
                </div>
            </div>
            <div class="form-group">
                <label for="inputEmail3" class="col-sm-2 control-label">开始日期:</label>
                <div class="col-sm-10">
                    <input type="text" class="form-control" value="" id="datepicker" name="from">

                </div>
            </div>
            <div class="form-group">
                <label for="inputEmail3" class="col-sm-2 control-label">结束日期:</label>
                <div class="col-sm-10">
                    <input type="text" class="form-control" value="" id="datepicker2" name="to">

                </div>
            </div>
            <div class="form-group">
                <div class="col-sm-10">
                    <label class="radio-inline">
                        <input type="checkbox"  value="1" name="lack_while">
                        半天 </label>
                    <!-- <label class="radio-inline"> 如果选择半天，则只计开始时间 </label>-->
                </div>
            </div>
            <div class="form-group">
                <label for="" class="col-sm-2  control-label">症状名称：</label>
                <div class="col-sm-10 ">
                    <select class="form-control" name="disease_id">
                        {%foreach from=$disease_lists key=key item=value%}
                        <option value="{%$value.disease_id%}">
                            {%$value.disease_name%} (代码：	{%$value.disease_code%})</option>
                        {%/foreach%}
                    </select>
                    <!--<div class="row" style="margin-top:8px">
                        <div class="col-xs-8">
                            <input id="new" placeholder="添加新的" class="form-control" >
                        </div>
                        <div  class="col-xs-4 "><span id="add"  class="btn btn-warning" >添加</span> </div>
                    </div>-->
                </div>
            </div>
            <div class="form-group">
                <label for="inputEmail3" class="col-sm-2 control-label">其他</label>
                <div class="col-sm-10">
                    <input type="text" class="form-control" name="lack_rests">
                </div>
            </div>
            <div class="form-group">
                <label for="inputEmail3" class="col-sm-2 control-label">就诊</label>
                <div class="col-sm-10">
                    <label class="choice"><input type="radio" name="lack_doctor"  value="1" name="lack_doctor"> 是</label>
                    <label class="choice"><input type="radio" name="lack_doctor"  value="2" name="lack_doctor"> 否</label>
                </div>
            </div>
            <div class="form-group">
                <label for="inputEmail3" class="col-sm-2 control-label">登记说明:</label>
                <div class="col-sm-10">
                    <p style="margin:0;">{%$explain_data.explain_content%}</p>
                </div>
            </div>
            <div class="box-footer text-center">
                <button type="submit" class="btn btn-primary">确定</button>
            </div>
        </form>
    </div>
    <!--row  end-->

    <!--<div class="row row_margin" > <a type="button" class="btn btn-primary btn-lg btn-block btn-primary2"  href="registration.html">确定</a> </div>-->
</div>
<!--container  end-->
<!--主体部分  end-->
<!--底部-->
{%include file="m.index.footer.tpl.php"%}
<!--container  end-->

<!--底部end-->
<script src="mstatic/js/jquery.min.js" type="text/javascript"></script>
<script src="mstatic/js/bootstrap.min.js"  type="text/javascript"></script>
<script src="mstatic/js/jquery-ui.js"  type="text/javascript"></script><!--日历--> 
<script>
    $(function() {
        $( "#datepicker" ).datepicker({

            changeMonth: true,
            changeYear: true

        });

        $( "#datepicker2" ).datepicker({

            changeMonth: true,
            changeYear: true

        });
    });
</script>
<script type="text/javascript">
    $(document).ready(function(){
        $("#new").hide();
        $("#add").hide();

        $("#add").click(function(){
            $("#s1").append("<option>"+$("#new").val()+"</option>");
            $("#new").val('');
        });
    });
    function a()
    {
        var val = $("#s1").val();
        if (val == '自定义') {
            $("#new").show();
            $("#add").show();
        } else{
            //alert(val);
        };
    }
</script>
</body>
</html>
